Respiratory Exam

Question 0

Classes of dyspnoea

Answer 0

Class 1 on heavy exertion
Class 2 on moderate exertion
Class 3 on minimal exertion
Class 4 at rest

Question 1

Causes of haemoptysis

Answer 1

Bronchitis
Bronchial carcinoma
Pneumonia
TB
Bronchiectasis 
Lung abscess
Pulmonary infarction
Goodpasture's syndrome
Foreign body
Vigorous coughing

Severe mitral stenosis
Acute LVF

Bleeding diathesis

Question 2

Causes of stridor

Answer 2

Acute
  Anaphylaxis
  Toxic gas inhalation
  Acute epiglottitis
  Inhaled foreign body

Insidious
  Laryngeal or pharyngeal tumour
  Crico- arytenoid rheumatoid arthritis
  Bilateral vocal cord palsy
  Tracheal carcinoma
  Para tracheal compression
  Post tracheostomy or intubation stenosis/ granulomata

Question 3

Causes of tracheal deviation

Answer 3

Towards side of lesion
Upper lobe collapse
Upper lobe fibrosis
Pulmonectomy

Away from side of lesion
Tension pneumothorax
Massive pleural effusion

Upper mediastinal masses eg goitre

Question 4

Causes of bronchial breath sounds

Answer 4

Lung consolidation

Localised pulmonary fibrosis
Pleural effusion - above the fluid
Collapsed lung - eg adjacent to pleural effusion

Question 5

Causes of Bronchiectasis

Answer 5

Congenital
Immobile cilia syndrome
CF
Congenital hypogammaglobulinaemia

Acquired
Childhood infection eg pertussis, pneumonia, measles
Localised disease eg foreign body, TB, bronchial adenoidal
Allergic bronchopulmonary aspergillosis

Question 6

Signs of severe Bronchiectasis

Answer 6

Clubbing
Copious sputum and haemoptysis
Sights of airway obstruction
Widespread crackles
Respiratory failure and cor pulmonale
Secondary amyloidosis

Question 7

Signs of severity in asthma

Answer 7

Mild PEFR and FEV1 > 75%, Sats >95

Moderate PEFR and FEV1 > 50% Sats >90 HR 100-120 Phrases

Severe PEFR and FEV1 < 50% Sats < 90 HR >120 Words

Extremis Can’t do PEFR Sats < 90 HR >140 or low Can’t speak

Question 8

Causes of interstitial lung disease

Diffuse tiny haze

Answer 8

Atypical
Sarcoidosis
Histiocytosis
Idiopathic 
Tumour - mets, lymphangitis
Failure
Autoimmune - SLE, RA, scleroderma
Collagen vascular disorder
Environmental - asbestosis, silicosis, coal
Drugs - methotrexate, amiodarone

Question 9

Severity of COPD

Answer 9

Mild FEV1 <40% pred

Question 10

Causes of upper zone pulmonary fibrosis

Ground glass, reticular
Linear and nodules
Dirty looking

Answer 10

Silicosis, sarcoidosis 
Eosinophilia pneumonia 
TB
Coal, CF
Aspergillosis, ank spondylitis
Radiation
PCP, pneumoconiosis

Question 11

Causes of lower zone pulmonary fibrosis

Answer 11

Bronchiectasis 
Aspiration
Drugs - amiodarone, hydralazine, methotrexate, smoke inhalation, paraquat, ntrofurantoin
RA
Asbestosis
Scleroderma
Histiocytosis

Question 12

Causes of “honeycomb” on CXR

Answer 12

Bleomycin
Idiopathic
Granulomas
Histiocytosis
Interstitial pneumonia
Pneumoconiosis 
Sarcoidosis

Question 13

Causes of pleural masses

Answer 13

Mesothelioma
Adenocarcinoma, asbestosis 
Lymphoma, leukaemia
Emphysema
Thy momma
Splenosis

Question 14

Causes of pulmonary nodules

Answer 14

Cancer - adenocarcinoma, mets, adenoma
Autoimmune - RA, Wegeners, granulomatosis
Vascular - AVM, Haematoma, PE, infarct
Infection - round pneumonia, military TB, fungal, varicella pneumonia
Environment - pleural plaques

Question 15

Causes of cavitating lung lesions

Answer 15

Cancer - SCC, Hodgkins
Autoimmune - sarcoidosis, granulomatosis, RA, progressive massive fibrosis, Wegner’s
Vascular - septic emboli, pulmonary infarct
Infection - Staph, klebsiella, Fungi, aspiration, gram negatives, secondary TB, infected bulla
Traumatic cyst
Young- bronchogenic cyst, laryngotracheal papillomatosis